(Gut 1996; 38: 932-935)

The advantage of EUS in the staging of anal cancer is that it allows precise assessment of the depth of infiltration and tumor spread into adjacent tissue, facilitating the choice of stage-dependent treatment decisions-particularly in determining the extent of interstitial booster radiotherapy needed. It also allows follow-up examinations after the initial treatment, with fine-needle aspiration biopsies of suspicious areas. Wider acceptance of this method might further decrease the performance of extensive surgery, with the impaired quality of life associated with rectal amputation. In addition, it might allow improved quality control of the various treatment modalities.

Tuberculosis should be included in the differential diagnosis in non-healing ulcers of the gastrointestinal tract, especially in immigrants from endemic areas.

Signs of chronic secretory diarrhoea suggest the possibility of an endocrinally active tumour. Search for a medullary carcinoma of the thyroid with measurement of the serum calcitonin level should be among the diagnostic procedures.

No abstract